Review ArticleSystematic Review
Open Access

Diagnostic approaches to and management options for patulous eustachian tube

Tawfiq Khurayzi, Saad Alenzi, Anwar Alshehri and Abdurrahman Alsanosi
Saudi Medical Journal June 2020, 41 (6) 572-582; DOI: https://doi.org/10.15537/smj.2020.6.25083

References

  1. ↵
    1. O'Connor AF,
    2. Shea JJ
    (1981) Autophony and the patulous eustachian tube. Laryngoscope 91:1427–1435.
    OpenUrlCrossRefPubMedWeb of Science
  2. ↵
    1. Grimmer JF,
    2. Poe DS
    (2005) Update on eustachian tube dysfunction and the patulous eustachian tube. Curr Opin Otolaryngol Head Neck Surg 13:277–282.
    OpenUrlCrossRefPubMed
  3. ↵
    1. Schilder A,
    2. Bhutta M,
    3. Butler C,
    4. Holy C,
    5. Levine L,
    6. Kvaerner K,
    7. et al.
    (2015) Eustachian tube dysfunction:consensus statement on definition, types, clinical presentation and diagnosis. Clin Otolaryngol 40:407–411.
    OpenUrl
  4. ↵
    1. Poe DS
    (2007) Diagnosis and management of the patulous eustachian tube. Otol Neurotol 28:668–677.
    OpenUrlPubMed
  5. ↵
    1. Llewellyn A,
    2. Norman G,
    3. Harden M,
    4. Coatesworth A,
    5. Kimberling D,
    6. Schilder A,
    7. et al.
    (2014) Interventions for adult Eustachian tube dysfunction:a systematic review. Health Technol Assess 18:1–180, v-vi.
    OpenUrlCrossRefPubMed
  6. ↵
    1. Hussein AA,
    2. Adams AS,
    3. Turner JH
    (2015) Surgical management of Patulous eustachian tube:A systematic review. Laryngoscope 125:2193–2198.
    OpenUrl
  7. ↵
    1. Moher D,
    2. Liberati A,
    3. Tetzlaff J,
    4. Altman DG
    (2009) Preferred reporting items for systematic reviews and meta-analyses:the PRISMA statement. Ann Intern Med 151:264–269, W64.
    OpenUrlCrossRefPubMedWeb of Science
  8. ↵
    1. Alli A,
    2. Shukla R,
    3. Cook JL,
    4. Waddell A
    (2019) A novel computed tomography guided, transcutaneous approach to treat refractory autophony in patients with a patulous Eustachian tube - A case series. J Laryngol Otol 133:201–204.
    OpenUrl
  9. ↵
    1. Ikeda R,
    2. Kawase T,
    3. Takata I,
    4. Suzuki Y,
    5. Sato T,
    6. Katori Y,
    7. et al.
    (2019) Width of Patulous Eustachian tube:comparison of assessment by Sonotubometry and Tubo-tympano-aerography. Otol Neurotol 40:e386–e392.
    OpenUrl
    1. Kim SJ,
    2. Shin SA,
    3. Lee HY,
    4. Park Y-H
    (2019) Paper patching for patulous eustachian tube. Acta Otolaryngol 139:122–128.
    OpenUrl
    1. Jancatova D,
    2. Zelenik K,
    3. Kominek P,
    4. Formanek M
    (2018) Saline injection to determine the volume required for personalised patulous Eustachian tube augmentation with long-standing material. J Laryngol Otol 132:1029–1031.
    OpenUrl
    1. Jeong J,
    2. Nam J,
    3. Han SJ,
    4. Shin SH,
    5. Hwang K,
    6. Moon IS
    (2018) Trans-tympanic cartilage chip insertion for intractable patulous Eustachian tube. J Audiol Otol 22:154–159.
    OpenUrl
    1. Jolly K,
    2. Darr A,
    3. Chavda SV,
    4. Ahmed SK
    (2018) Patulous Eustachian tube obliteration using endovascular coils:A novel technique. J Laryngol Otol 132:564–566.
    OpenUrl
  14. ↵
    1. Kikuchi T,
    2. Ikeda R,
    3. Oshima H,
    4. Takata I,
    5. Kawase T,
    6. Oshima T,
    7. et al.
    (2017) Effectiveness of Kobayashi plug for 252 ears with chronic patulous Eustachian tube. Acta Oto-Laryngologica 137:253–258.
    OpenUrl
    1. Endo S,
    2. Mizuta K,
    3. Takahashi G,
    4. Nakanishi H,
    5. Yamatodani T,
    6. Misawa K,
    7. et al.
    (2016) The effect of ventilation tube insertion or trans-tympanic silicone plug insertion on a patulous Eustachian tube. Acta Oto-Laryngologica 136:551–555.
    OpenUrl
    1. Mackeith SA,
    2. Bottrill ID
    (2016) Polydimethylsiloxane elastomer injection in the management of the patulous eustachian tube. J Laryngol Otol 130:805–810.
    OpenUrl
    1. Oh S,
    2. Lee IW,
    3. Goh EK,
    4. Kong SK
    (2016) Endoscopic autologous cartilage injection for the patulous eustachian tube. Am J Otolaryngol 37:78–82.
    OpenUrl
    1. Si Y,
    2. Chen Y,
    3. Li P,
    4. Jiang H,
    5. Xu G,
    6. Li Z,
    7. et al.
    (2016) Eardrum thickening approach for the treatment of patulous Eustachian tube. Eur Arch Otorhinolaryngol 273:3673–3678.
    OpenUrl
    1. Oh SJ,
    2. Lee IW,
    3. Goh EK,
    4. Kong SK
    (2015) Trans-tympanic catheter insertion for treatment of patulous eustachian tube. Am J Otolaryngol 36:748–752.
    OpenUrl
    1. Schroder S,
    2. Lehmann M,
    3. Sudhoff HH,
    4. Ebmeyer J
    (2015) Treatment of the patulous Eustachian tube with soft-tissue bulking agent injections. Otol Neurotol 36:448–452.
    OpenUrl
    1. Boedts M
    (2014) Paper patching of the tympanic membrane as a symptomatic treatment for patulous eustachian tube syndrome. J Laryngol Otol 128:228–235.
    OpenUrl
    1. Brace MD,
    2. Horwich P,
    3. Kirkpatrick D,
    4. Bance M
    (2014) Tympanic membrane manipulation to treat symptoms of patulous eustachian tube. Otol Neurotol 35:1201–1206.
    OpenUrl
    1. Oh SJ,
    2. Kang DW,
    3. Goh EK,
    4. Kong SK
    (2014) Calcium hydroxylapatite injection for the patulous Eustachian tube. Am J Otolaryngol 35:443–444.
    OpenUrl
    1. Rodrigues JC,
    2. Waddell A,
    3. Cook JL
    (2014) A novel, computed tomography guided, trans-cutaneous approach to treat refractory autophony in a patient with a patulous eustachian tube. J Laryngol Otol 128:182–184.
    OpenUrl
    1. Rotenberg B,
    2. Davidson B
    (2014) Endoscopic transnasal shim technique for treatment of patulous eustachian tube. Laryngoscope 124:2466–2469.
    OpenUrl
    1. Vaezeafshar R,
    2. Turner JH,
    3. Li G,
    4. Hwang PH
    (2014) Endoscopic hydroxyapatite augmentation for patulous eustachian tube. Laryngoscope 124:62–66.
    OpenUrl
    1. Rotenberg BW,
    2. Busato GM,
    3. Agrawal SK
    (2013) Endoscopic ligation of the patulous eustachian tube as treatment for autophony. Laryngoscope 123:239–243.
    OpenUrl
  28. ↵
    1. Ikeda R,
    2. Oshima T,
    3. Oshima H,
    4. Miyazaki M,
    5. Kikuchi T,
    6. Kawase T,
    7. et al.
    (2011) Management of patulous eustachian tube with habitual sniffing. Otol Neurotol 32:790–793.
    OpenUrlPubMed
    1. Kong SK,
    2. Lee IW,
    3. Goh EK,
    4. Park SH
    (2011) Autologous cartilage injection for the patulous eustachian tube. Am J Otolaryngol 32:346–348.
    OpenUrlPubMed
    1. Yanez C,
    2. Pirron JA,
    3. Mora N
    (2011) Curvature inversion technique:A novel tuboplastic technique for patulous Eustachian tube - A preliminary report. Otolaryngol Head Neck Surg 145:446–451.
    OpenUrlCrossRefPubMed
    1. Bartlett C,
    2. Pennings R,
    3. Ho A,
    4. Kirkpatrick D,
    5. Van Wijhe R,
    6. Bance M
    (2010) Simple mass loading of the tympanic membrane to alleviate symptoms of patulous Eustachian tube. J Otolaryngol Head Neck Surg 39:259–268.
    OpenUrl
  32. ↵
    1. Oshima T,
    2. Kikuchi T,
    3. Kawase T,
    4. Kobayashi T
    (2010) Nasal instillation of physiological saline for patulous eustachian tube. Acta Otolaryngol 130:550–553.
    OpenUrlPubMed
    1. Wolraich D,
    2. Zur KB
    (2010) Use of calcium hydroxylapatite for management of recalcitrant otorrhea due to a patulous eustachian tube. Int J Pediatr Otorhinolaryngol 74:1455–1457.
    OpenUrlCrossRefPubMed
    1. Olthoff A,
    2. Laskawi R,
    3. Kruse E
    (2007) Successful treatment of autophonia with botulinum toxin:Case report. Ann Otol Rhinol Laryngol 116:594–598.
    OpenUrlCrossRefPubMed
    1. Takano A,
    2. Takahashi H,
    3. Hatachi K,
    4. Yoshida H,
    5. Kaieda S,
    6. Adachi T,
    7. et al.
    (2007) Ligation of eustachian tube for intractable patulous eustachian tube:A preliminary report. Eur Arch Otorhinolaryngol 264:353–357.
    OpenUrlCrossRefPubMed
    1. Sato T,
    2. Kawase T,
    3. Yano H,
    4. Suetake M,
    5. Kobayashi T
    (2005) Trans-tympanic silicone plug insertion for chronic patulous Eustachian tube. Acta Otolaryngol 125:1158–1163.
    OpenUrlPubMed
    1. Doherty JK,
    2. Slattery Iii WH
    (2003) Autologous fat grafting for the refractory patulous Eustachian tube. Otolaryngol Head Neck Surg 128:88–91.
    OpenUrlCrossRefPubMed
    1. Boudewyns A,
    2. Claes J
    (2001) Acute cochleovestibular toxicity due to topical application of potassium iodide. Eur Arch Otorhinolaryngoly 258:109–111.
    OpenUrl
    1. DiBartolomeo JR,
    2. Henry DF
    (1992) A new medication to control patulous eustachian tube disorders. Am J Otol 13:323–327.
    OpenUrlCrossRefPubMedWeb of Science
    1. Dyer Jr RK,
    2. McElveen Jr JT
    (1991) The patulous eustachian tube:Management options. Otolaryngol Head Neck Surg 105:832–835.
    OpenUrlCrossRefPubMed
    1. Chen DA,
    2. Luxford WM
    (1990) Myringotomy and tube for relief of patulous eustachian tube symptoms. Am J Otol 11:272–273.
    OpenUrlPubMed
    1. Hazell JWP,
    2. Robinson PJ
    (1989) Patulous Eustachian tube syndrome:The relationship with sensorineural hearing loss treatment by Eustachian tube diathermy. J Laryngol Otol 103:739–742.
    OpenUrlCrossRefPubMed
    1. Morita M,
    2. Matsunaga T
    (1988) Effects of an anti-cholinergic on the function of patulous eustachian tube. Acta Otolaryngol Suppl 458:63–66.
    OpenUrlPubMed
    1. Virtanen H,
    2. Palva T
    (1982) Surgical treatment of patulous eustachian tube. Arch Otolaryngol 108:735–739.
    OpenUrlCrossRefPubMed
    1. Bluestone CD,
    2. Cantekin EI
    (1981) “How I do it”--otology and neurotology. A specific issue and its solution. Management of the patulous Eustachian tube. Laryngoscope 91:149–152.
    OpenUrlPubMedWeb of Science
    1. Crary WG,
    2. Wexler M,
    3. Berliner K
    (1979) The abnormally patent Eustachian tube:alterations in psychological status resulting from polytef paste injections. Arch Otolaryngol 105:21–23.
    OpenUrlCrossRefPubMed
    1. Ogawa S,
    2. Satoh I,
    3. Tanaka H
    (1976) Patulous Eustachian tube. A new treatment with infusion of absorbable gelatin sponge solution. Arch Otolaryngol 102:276–280.
    OpenUrlCrossRefPubMedWeb of Science
  48. ↵
    1. Bhide AR
    (1976) Dizziness due to patulous eustachian tube. Indian J Otolaryngol 28:148.
    OpenUrl
    1. Stroud MH,
    2. Spector GJ,
    3. Maisel RH
    (1974) Patulous Eustachian tube syndrome. Preliminary report of the use of the tensor veli palatini transposition procedure. Arch Otolaryngol 99:419–421.
    OpenUrlCrossRefPubMedWeb of Science
    1. Misurya VK
    (1974) Surgical treatment of the abnormally patulous eustachian tube. J Laryngol Otol 88:877–883.
    OpenUrlPubMedWeb of Science
    1. Pulec JL
    (1967) Abnormally patent eustachian tubes:Treatment with injection of poly-tetrafluoroethylene (teflon) paste. Laryngoscope 77:1543–1554.
    OpenUrlCrossRefPubMedWeb of Science
    1. Thaler S,
    2. Yanagisawa E
    (1966) The abnormally patent eustachian tube. Arch Otolaryngol 84:418–421.
    OpenUrlCrossRefPubMed
  53. ↵
    1. Miller JB
    (1961) Patulous Eustachian Tube:report of 30 cases. Arch Otolaryngol 73:310–321.
    OpenUrlCrossRefPubMed
  54. ↵
    1. Moore PM,
    2. Miller JB
    (1951) Patulous Eustachian tube. AMA Arch Otolaryngol 54:643–650.
    OpenUrlCrossRefPubMed
  55. ↵
    1. Bance M,
    2. Tysome JR,
    3. Smith ME
    (2019) Patulous Eustachian tube (PET), a practical overview. World J Otorhinolaryngol Head Neck Surg 5:137–142.
    OpenUrl
    1. Marcano Acuna M,
    2. Dalmau Galofre J,
    3. Balaguer Garcia R,
    4. Agostini Porras G
    (2013) Uncommon aetiology for autophony:Patulous Eustachian tube. Acta Otorrinolaringol Esp 64:237–239.
    OpenUrl
    1. Pyne JM,
    2. Lawen TI,
    3. Floyd DD,
    4. Bance M
    (2018) The 678 Hz acoustic immittance probe tone:a more definitive indicator of PET than the traditional 226 Hz method. J Otolaryngol Head Neck Surg 47:43.
    OpenUrl
    1. Smith ME,
    2. Cochrane IL,
    3. Donnelly N,
    4. Axon PR,
    5. Tysome JR
    (2018) The performance of patient-reported outcome measures as diagnostic tools for eustachian tube dysfunction. Otol Neurotol 39:1129–1138.
    OpenUrl
    1. Pyne JM,
    2. Amoako-Tuffour Y,
    3. Earle G,
    4. McIntyre G,
    5. Butler MB,
    6. Bance M
    (2017) Transmission of a novel sonotubometry acoustic click stimulus in healthy and patulous eustachian tube subjects:A retrospective case -control study. J Otolaryngol Head Neck Surg 46:47.
    OpenUrl
  60. ↵
    1. Paradis J,
    2. Bance M
    (2015) Assessment of nasal-noise masking audiometry as a diagnostic test for patulous Eustachian tube. Otol Neurotol e36, 36, e41.
  61. ↵
    1. Oonk AM,
    2. Steens SC,
    3. Pennings RJ
    (2014) Radiologic confirmation of patulous eustachian tube by recumbent computed tomography. Otol Neurotol e117, 35, e118.
    1. Kikuchi T,
    2. Oshima T,
    3. Hori Y,
    4. Kawase T,
    5. Kobayashi T
    (2009) Three-dimensional computed tomography imaging of the eustachian tube lumen in patients with patulous eustachian tube. ORL J Otorhinolaryngol Relat Spec 71:312–316.
    OpenUrlPubMed
    1. Kikuchi T,
    2. Oshima T,
    3. Ogura M,
    4. Hori Y,
    5. Kawase T,
    6. Kobayashi T
    (2007) Three-dimensional computed tomography imaging in the sitting position for the diagnosis of patulous Eustachian tube. Otol Neurotol 28:199–203.
    OpenUrlCrossRefPubMed
  64. ↵
    1. Hori Y,
    2. Kawase T,
    3. Hasegawa J,
    4. et al.
    (2006) Audiometry with nasally presented masking noise:Novel diagnostic method for patulous eustachian tube. Otol Neurotol 27:596–599.
    OpenUrlPubMed
  65. ↵
    1. Yoshida H,
    2. Kobayashi T,
    3. Morikawa M,
    4. Hayashi K,
    5. Tsujii H,
    6. Sasaki Y
    (2003) CT imaging of the patulous eustachian tube - Comparison between sitting and recumbent positions. Auris Nasus Larynx 30:135–140.
    OpenUrlPubMed
  66. ↵
    1. Virtanen H
    (1978) Patulous Eustachian tube. Diagnostic evaluation by sonotubometry. Acta Otolaryngol 86:401–407.
    OpenUrlPubMed
  67. ↵
    1. Bance M,
    2. Tysome JR,
    3. Smith ME
    (2019) Patulous Eustachian tube (PET), a practical overview. World J Otorhinolaryngol Head Neck Surg 5:137–142.
    OpenUrl
    1. Marcano Acuna M,
    2. Dalmau Galofre J,
    3. Balaguer Garcia R,
    4. Agostini Porras G
    (2013) Uncommon aetiology for autophony:Patulous eustachian tube. Acta Otorrinolaringol Esp 64:237–239.
    OpenUrl
    1. Luu K,
    2. Remillard A,
    3. Fandino M,
    4. Saxby A,
    5. Westerberg BD
    (2015) Treatment effectiveness for symptoms of patulous Eustachian tube:A systematic review. Otol Neurotol 36:1593–1600.
    OpenUrl
Back to top

In this issue

Print
Download PDF
Email Article
Citation Tools
Bookmark this article

Jump to section

Keywords